According to a Reuter’s report, CVS plans to open 300 new Minute Clinics in 2007.
Is this going to change the way doctor’s offices fundamentally do business? In the long-term, I think so, because right now they can’t compete with retail convenience. In multi-doc office, I expect to see doctor/NP/PA scheduling altering to have a more or less constant presence in the office. This will be particularly true with NPs and PAs who can handle more immediate issues — the things that will be diagnosed at Minute Clinics.
There’s been lots of talk in the medical blogging community about how Minute Clinics are “bad” in the sense that a patient’s medical history will be spread out over multiple locations. That the treatment prescribed by the NP at the Minute Clinic will be sub-par, or not what one’s PCP would have chosen. These are valid complaints, so I expect to see doctors respond in the areas where Minute Clinic density is higher.
You don’t need a large medical practice to cover a lot of hours. Lots of hours = lots of availability. Sure it’s not as nice as a 7-7 medical practice, but it IS more convenient for the patients/customers. And it has unexpected benefits as well — 3 days weekends once a month and the like are not uncommon for pharmacists.
Realistically, a moderately-sized medical practice (3 docs, say) could easily cover 72 hours of availability per week. 8am-8pm Monday through Friday, and 9am-3pm on Saturday and Sunday. Start with one doctor in the morning, have the second come in later in the day, say around 11am or noon, and doctor #1 goes home around 4-5pm while his/her colleague stays until late. This is what retail pharmacists do, and I expect you’ll see variations on this theme for doctors once they start feeling the pressure from retail clinician availability. Get an NP or a PA to see the urgent cases, and I think you could probably cut down on ER overuse in your area.
Are there problems? Yes. Are the insurmountable? No. Will it happen in the next five years? Probably. Think about it. 300 Minute Clinics in 2007 alone. If they become big hits, expect to see that number grow yearly. That’s a lot of Minute Clinics. That’s a lot of lost, easy revenue.*
*I think it was Flea(?) who said that these types of visits are the bread and butter of pediatricians because they’re fast and easy. These are the types of visitors the Minute Clinics are catering to.
[tags]Medicine, pharmacy, CVS, Minute Clinic, retail medicine[/tags]
I am not certain who wrote the aforementioned comment regarding the Reuters report, but I do take issue with some of statements. The reality of the health-care world in which we practice is such that NPs and PAs are currently seeing many complicated presentations in the office setting, along with the “fast and easy” presentations (much could be said about this conclusion also…another time perhaps). This is all with the blessing of the physicians in the office who collect a percentage of the billing after salary expenses/overhead costs for the NP or PA.
To now say that the care provided will be “sub-par” if provided by a NP is questionable at best. One is led to ask why is the NP an appropriate provider in the office setting (and those of us in practice know there is no physician involvement in the evaluation/treatment of nearly all patients…often the physician is not present) but a “sub-par” provider in another practice setting?
It seems many of these concerns regarding patient care are really smoke-screens for FINANCIAL concerns. Numerous studies have now documented that treatment provided by a Nurse Practitioner in no way comprises patient care. In fact, in some instances, it has been found to have more favorable outcomes.
The answers for physicians will be quite simple and MeD thru within their offices will show that shortly. A patent pending on the easy scheduling system and more credible and visible than Ketchup Aisle medicine. Yes, the doctors can open these quickly and thousands of outlets are possible with very little build-out. Continuity of care is not the issue, and volume is not a problem as Retail has issues. The patients are loyal and the doctors have the patient charts. The service will be launched to and for physicians and I would not worry about the retail medicine chains no matter what the PR. Urgent care is at risk.
Dr. David B. Foy
President of MeD thru
The comments above are inaccurate. I have many patients that use Minute Clinic and my profits have not decreased. They have increased because of referrals. The company has gone to great lengths to ensure best practice standards. My schedule is often extremely full and scheduling is difficult. The majority of care is covered by the patients insurance. I always receive a copy of the note and the patients are referred back to me for follow up. IÂ’ve also received referrals from the clinics when a patient does not have a primary care physician. We as physicians let our ego get in the way. We need to be more focused on access and what is best for the patient.
Thanks for your comments. I’m glad to hear they’re not cutting into your business. Now if only the Ivory Tower types would get this into their heads…
I HAVE VISITED THE MINUTE CLINIC IN MY HOME TOWN 4 TIMES NOW, ALL FOR SINUS OR SORE THROAT ISSUES. I CONSIDER MYSELF LUCKY THAT I HAVE HEALTH INSURANCE AND ALSO HAVE A PRIMARY PHYSICIAN. MY INSURANCE COMPANY RECENTLY SENT OUT INFORMATION ON THE MINUTE CLINICS AND HOW ITS MORE COST EFFECTIVE THAN A DOCTORS OFFICE VISIT. THREE OF MY FOUR VISITS WERE PLEASANT AND FAST. HOWEVER MY LAST VISIT WAS VERY DISAPPOINTING. THE NURSE PRACTIONER WAS RUDE AND VERY UNPROFESSIONAL. I LEFT FEELING WORSE THAN I WENT IN AND AFTER SEEING THAT $100.00 WAS BEING BILLED TO MY INSURANCE COMPANY FOR NO SERVICE AND ACTUALLY HORRIBLE SERVICE, I NOW HAVE TO MAKE AN APPOINTMENT TO SEE MY PRIMARY PHYSICIAN AND THIS IS JUST MORE OF A WASTE OF MY TIME AND MY INSURANCE DOLLARS. THIS ONE EXPERIENCE WILL NOT DETER ME FROM GOING TO A MINUTE CLINIC AGAIN AS IT IS A COST EFFECTIVE CONVIENANT MEANS FOR A QUICK CHECK ON MINOR HEALTH ISSUES. THIS N/P MAY HAVE SUFFERED FROM THE SAME STRESS THAT YOUR FAST FOOD WORKERS FEEL AS THIS IS ALMOST EQUIVILIENT TO DRIVE THRU MEDICINE.
This a copy of an e-mail I sent to the MinuteClinic investors link in the CVS site based on my visit to Minuteclinc yesterday and today.
By the way, I received a Delivery Status Notification (Failure)when I sent this. Do they really exist?
_____________________________________________________________________________________________________________________________
I went to the Minute Clinic CVS in Smyrna,TN on 12-8-2008. I have a sore
throat. My throat also had white blisters on it as verified by family
members. I lost my job of 30 years, as many others have, 11-25-08. My
medical benefits stopped on that date so , after research on the internet, I
found out about Minuteclinic. The APN on duty that day stated
she did not see anything wrong with my throat. She took a throat culture and
put it in some kind of gel and started a stop watch that was set at 5
minutes. 3 minutes into the test she said it was negative. She refused to
write a prescription for the antibiotics I needed. I have had this same
infection before and know this will fix my problem. It seems to show up at
the same time each year. She said if I paid 30 more dollars, she would send
the culture to a lab to have it verified and would take 24 to 48 hours. She
told me it was just sinus drainage and told me to take acetaminophen 325 mg
for pain and fever. (I guess she knew I was in pain). I realized this would
not cure my throat infection. The next day I call the Minuteclinic toll free
number and explained my situation to the rep that answered the phone. She
said to go back and see her again but could not promise I would get the
medicine I needed. I went back and signed in again. While waiting, I went to
the pharmacist on duty and showed him my throat with a mag-light I took with
me. He saw the blisters on my throat. I asked why she wouldn’t write a
prescription with such visible signs of a throat infection. He stated I’m
not the first to complain. He also said that less than a third of the
patients that go to Minuteclinic at that location do not get the medication
they need. On my way out I told the store manager what I just experienced.
There was nothing he could do. I understand that. Nothing against him. I
then asked the cashier to look at my throat. She confirmed she could see the
white blisters on my throat as the pharmacist did. I called the toll free
number again and explained my experience. She stated there was nothing she
could do.
I then started searching the CVS site and found this link as my starting
point. I would not recommend Minuteclinic to anyone
aside from getting a flu shot. I would have to advise your investors to be
weary of choosing your company to give their money to based on my
experience. With unemployment at a 30 year high and more people loosing
their job every day, it’s a shame to lure people into Minuteclinic with the
false hope of getting the medicine they need. This is my first attempt to
correct something that is obviously wrong. Less than one third get what they
need. Do the math. Seems to be a lot of money to be made at the expense of
jobless people with no medical benefits. It’s just not right. Greed is going
to be the downfall of his country. Ford, General Motors, and Chrysler are
current examples. The Big Three. Maybe it should be The Big Four.
Gotta go now. I now have something to do with my spare time.